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Risk score comparison of outcomes in patients presenting with ST-elevation myocardial infarction treated with percutaneous coronary intervention.
Eur J Cardiovasc Nurs. 2013 Aug; 12(4):330-6.EJ

Abstract

BACKGROUND

Accurate risk stratification is important in the management of acute coronary syndrome (ACS) patients. Several risk scores have been developed to stratify patients hospitalized with ACS.

AIM

To compare the prognostic value of three risk scores used to determine the risk for secondary events in patients diagnosed with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

METHODS

A retrospective analysis of patients with an ACS experiencing a STEMI treated with PCI presenting to a Kaiser Permanente Foundation Hospital in Northern California from January 2007 to January 2008 (n=186). For each patient, the Thrombolysis in Myocardial Infarction (TIMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty complications (CADILLAC), and Global Registry for Acute Coronary events (GRACE) risk scores were calculated and predictive ability was analysed using the area under the curve or C statistic method.

RESULTS

The CADILLAC, TIMI, and GRACE risk scores all had high predictive accuracy for a major cardiac event in hospital, with C statistics ranging from 0.63 to 0.718 with the CADILLAC risk score superior. For non-major cardiac events in hospital, the three risk scores were similar in accuracy for predictability, with C statistics ranging from 0.62 to 0.66.

CONCLUSIONS

Risk stratification of patients with STEMI undergoing primary percutaneous coronary intervention can be done using all three risk scores. In our analysis, the CADILLAC and GRACE score was more predictive for major cardiac events in hospital and CADILLAC and TIMI for major cardiac events at 1 year.

Authors+Show Affiliations

St Vincent's/ACU Centre for Nursing Research, School of Nursing and Midwifery, Faculty of Health Sciences, Australian Catholic University National, Melbourne, Australia. Elizabeth.Scruth@kp.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22694809

Citation

Scruth, Elizabeth Ann, et al. "Risk Score Comparison of Outcomes in Patients Presenting With ST-elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention." European Journal of Cardiovascular Nursing : Journal of the Working Group On Cardiovascular Nursing of the European Society of Cardiology, vol. 12, no. 4, 2013, pp. 330-6.
Scruth EA, Cheng E, Worrall-Carter L. Risk score comparison of outcomes in patients presenting with ST-elevation myocardial infarction treated with percutaneous coronary intervention. Eur J Cardiovasc Nurs. 2013;12(4):330-6.
Scruth, E. A., Cheng, E., & Worrall-Carter, L. (2013). Risk score comparison of outcomes in patients presenting with ST-elevation myocardial infarction treated with percutaneous coronary intervention. European Journal of Cardiovascular Nursing : Journal of the Working Group On Cardiovascular Nursing of the European Society of Cardiology, 12(4), 330-6. https://doi.org/10.1177/1474515112449412
Scruth EA, Cheng E, Worrall-Carter L. Risk Score Comparison of Outcomes in Patients Presenting With ST-elevation Myocardial Infarction Treated With Percutaneous Coronary Intervention. Eur J Cardiovasc Nurs. 2013;12(4):330-6. PubMed PMID: 22694809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk score comparison of outcomes in patients presenting with ST-elevation myocardial infarction treated with percutaneous coronary intervention. AU - Scruth,Elizabeth Ann, AU - Cheng,Eugene, AU - Worrall-Carter,Linda, Y1 - 2012/06/13/ PY - 2012/6/15/entrez PY - 2012/6/15/pubmed PY - 2014/3/13/medline KW - Acute coronary syndromes KW - CADILLAC KW - GRACE KW - ST-elevation myocardial infarction KW - TIMI SP - 330 EP - 6 JF - European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology JO - Eur J Cardiovasc Nurs VL - 12 IS - 4 N2 - BACKGROUND: Accurate risk stratification is important in the management of acute coronary syndrome (ACS) patients. Several risk scores have been developed to stratify patients hospitalized with ACS. AIM: To compare the prognostic value of three risk scores used to determine the risk for secondary events in patients diagnosed with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: A retrospective analysis of patients with an ACS experiencing a STEMI treated with PCI presenting to a Kaiser Permanente Foundation Hospital in Northern California from January 2007 to January 2008 (n=186). For each patient, the Thrombolysis in Myocardial Infarction (TIMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty complications (CADILLAC), and Global Registry for Acute Coronary events (GRACE) risk scores were calculated and predictive ability was analysed using the area under the curve or C statistic method. RESULTS: The CADILLAC, TIMI, and GRACE risk scores all had high predictive accuracy for a major cardiac event in hospital, with C statistics ranging from 0.63 to 0.718 with the CADILLAC risk score superior. For non-major cardiac events in hospital, the three risk scores were similar in accuracy for predictability, with C statistics ranging from 0.62 to 0.66. CONCLUSIONS: Risk stratification of patients with STEMI undergoing primary percutaneous coronary intervention can be done using all three risk scores. In our analysis, the CADILLAC and GRACE score was more predictive for major cardiac events in hospital and CADILLAC and TIMI for major cardiac events at 1 year. SN - 1873-1953 UR - https://www.unboundmedicine.com/medline/citation/22694809/Risk_score_comparison_of_outcomes_in_patients_presenting_with_ST_elevation_myocardial_infarction_treated_with_percutaneous_coronary_intervention_ L2 - https://journals.sagepub.com/doi/10.1177/1474515112449412?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -